1. Field of the Invention
This invention pertains in general to the field of medical x-ray diagnostics and in particular to the field of medical mammographs to detect early stages of cancer in a woman's breasts.
2. Description of the Prior Art
Breast cancer in women is, of course, a very serious medical problem. Once a malignancy is found, the typical medical procedure is to remove one or both breasts immediately. Should the malignancy continue to spread because the cancer has not been earlier diagnosed or the removal operation occurred too late, the result can be fatal. Accordingly, the earliest possible detection of breast cancer and the earliest possible removal of the malignancy is of the utmost urgency.
Certain types of breast cancer which is in a later stage of development can easily be determined by a physical examination of the breasts to determine the presence of lumps. Once such lumps are determined to exist, the next step is to perform a biopsy to determine if the lump is malignant or benign. Should the lump be malignant, the remedy is, of course, partial removal of the portion of the breast which contains the lump or complete removal of one or both of the breasts. Since the presence and location of the lump is readily ascertainable by a physical examination, removal of the lump for biopsy examination is a relatively simple task. However, should the cancer be in an earlier stage of development, the detection thereof, the exact location thereof within the breasts, and the removal of the same for immediate biopsy examination become difficult tasks.
The early stages of malignancy or cancer in a breast manifests itself by a cluster of microcalcifications which comprise a plurality of spaced fine spicules of calcium which are visible on a mammogram as very tiny dots. Since the spicules are comprised of calcium, they appear as light or undeveloped dots on the x-ray film.
Once such early signs of malignancy are determined by a mammogram, the roentgenologist, with the aid of fluoroscopy, physically locates the same within a breast by using a pair of very thin elongated needle wires under fluoroscopic guidance. In this regard the roentgenologist will insert one wire needle into the breast along a line parallel to the longitudinal axis of a person's body. Then, he will insert another wire into the breast at right angles to the first wire with the points of both wires being placed at the precise location of the cluster of microcalcifications. The surgeon then cuts into the breast and removes the portion of the breast tissue which he believes includes the cluster of microcalcifications. Once this sample is removed from the breast, the locating guide wires are, of course, removed therefrom. Typically, while the woman is still within the operating room and under anesthesia, the breast sample is then sent to the pathology laboratory where the sample is sandwiched between a pair of plates thereby compressing the sample tissue biopsy into a flattened shape. The flattened shape of the sample is then x-rayed and the film developed to determine the presence and location of the spicules of calcium. If spicules are not found with x-ray, the pathologist sends a message, or calls, the surgeon in the operating room and tells him he failed to remove that portion with the calcifications. The surgeon then has to remove more breast tissue which is again given to the pathologist who repeats the procedure of sandwiching the tissue sample and x-raying the same. Upon determining the presence and location of spicules, the sample is then frozen and cut into very fine slices (25/1000 of an inch) which may be placed under a microscope after a staining procedure and examined. Should the pathologist find that the tissue with calcifications are malignant, the results are immediately sent to the operating surgeon who then removes the appropriate portion or the entire breast or breasts of the patient.
In accordance with the above it is obvious that time is of the essence while the pathologist is preparing the sample of the breast tissue for x-ray examination and then preparing further samples for microscopic examination to determine if calcifications are present, and whether or not the sample is malignant. In the prior art the main constraining time factor involves locating the cluster of calcifications within the tissue sample and then sectioning that portion of the sample which contains the calcifications. Because the pathologist can only use a mammograph to determine the approximate location of the calcifications within the sample and because the sample tends to contract once the sandwiching pressure is removed, the pathologist can only guess where the calcifications are and must therefore prepare a larger than necessary number of slivers of the specimen for microscopic examination. During this relatively extended period of time, as mentioned above, the patient and the entire surgical operating team are patiently waiting in the operating room for the results of the biopsy examination of one and maybe more tissue specimens. Accordingly, new apparatus and methods are desirable to reduce the time of the pathological examination of the specimens.
Accordingly, a primary object of the present invention is to provide apparatus and methods which significantly shorten the time between the removal of a test sample of a patient's breast suspected of containing early stages of cancer and the microscopic examination of the same to determine if malignancy exists.
Another object of the present invention is to significantly shorten the time of a biopsy examination of a test portion of a person's breasts suspected of containing early calcifications found in early stages of cancer.
Another object of the present invention is to provide apparatus and methods which allows a pathologist to rapidly locate and remove a small portion of a large test specimen, which small portion is suspected to contain early stages of cancer.
The above-stated objects as well as other objects which, although not specifically stated, but are intended to be included within the scope of the present invention, are accomplished by the present invention and will become apparent from the hereinafter set forth Detailed Description of the Invention, Drawings, and the claims appended herewith.